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Valliere v. Commissioner of Social Services

Supreme Court of Connecticut

February 1, 2018

PAUL VALLIERE ET AL.
v.
COMMISSIONEROF SOCIAL SERVICES

          Argued September 12, 2017 [**]

         Appeal from the decision of the defendant calculating certain Medicaid benefits, broughtto the Superior Court in the judicial district of New Britain and tried to the court, Noble, J.; judgment sustaining the appeal, from which the defendant appealed. Affirmed.

          Jennifer L. Callahan, assistant attorney general, with whom, on the brief, were George Jepsen, attorney general, and Hugh Barber, assistant attorney general, for the appellant (defendant).

          Carmine Perri, with whom, on the brief, was Bruce A. Fontanella, for the appellees (plaintiffs).

          Daniel J. Klau filed a brief for the Office of the Probate Court Administrator as amicus curiae.

          Rogers, C. J., and Eveleigh, McDonald, Robinson, Vertefeuille and Espinosa, Js. [*]

          OPINION

          ROBINSON, J.

         In this appeal, we consider the relationship between General Statutes § 45a-655 (b) and (d)[1] in determining whether a spousal support order previously rendered by the Probate Court is binding on the defendant, the Commissioner of Social Services (commissioner), when calculating the allowance that may be diverted to the support of the community spouse of a Medicaid eligible institutionalized person pursuant to 42 U.S.C. § 1396r-5, a provision originally enacted as part of the Medicare Catastrophic Coverage Act of 1988 (catastrophic coverage act), Pub. L. No. 100-360, § 303 (a) (1) (B), 102 Stat. 683, 754. The commissioner appeals[2] from the judgment of the trial court sustaining the administrative appeal brought by the plaintiffs, Paul Valliere (Paul) and Ellen Shea, conservatrix and executrix of the estate of Marjorie Valliere (Marjorie), from the commissioner's decision to set a community spouse allowance for Paul in the amount of $0 with respect to the Medicaid benefit that paid for his wife Marjorie's long-term residential care. On appeal, the commissioner contends that, because § 45a-655 (b) and (d) must be construed in light of the federal single state agency requirement that is implemented by General Statutes § 17b-261b, [3] the trial court improperly concluded that the community spouse allowance was controlled by a spousal support order rendered by the Probate Court prior to the application for, and award of, Medicaid benefits. We disagree and, accordingly, affirm the judgment of the trial court.

         The record reveals the following undisputed facts and relevant procedural history. On November 18, 2012, Marjorie was admitted to the MidState Medical Center (MidState). On November 24, 2012, MidState discharged Marjorie to the Meriden Center skilled nursing facility, where she resided until her death on October 17, 2013. Paul continued to reside in their family home in Meri-den. On March 18, 2013, the Probate Court appointed Shea, Marjorie's daughter, as conservatrix of Marjo-rie's estate.[4]

         On March 21, 2013, Shea filed an application in the Probate Court seeking an order of spousal support for Paul pursuant to § 45a-655, contending that, in order to continue to reside in the community and pay the cost of his own ‘‘support, maintenance and medical treatment, ''[5] Paul needed to ‘‘own, use and exercise control over all or some of the [nonincome] producing assets, the income producing assets, [Marjorie's] total net income and [his own] total net income, all retroactive to March 18, 2013, '' the date that the Probate Court appointed Shea as conservatrix. The application further represented that Marjorie was ‘‘not receiving public assistance, state administered general assistance, or Medicaid, and [she] has not applied for or is receiving such medical assistance, but [she] reserves, and does not waive, her right to prepare, file and prosecute in the future [an] application, claiming [Medicaid] benefits.'' (Emphasis in original.) Shea provided notice of the application to the commissioner and to the Department of Administrative Services.

         Following a hearing, on June 25, 2013, the Probate Court issued a decree, pursuant to §§ 45a-655 (a) and (b), and 17b-261b, which made findings in accordance with the representations in the application, namely, that, ‘‘[i]n order to continue to reside in the community and pay the cost of [his own] support, maintenance and medical treatment, '' Paul ‘‘now requires, and in the future will continue to require, to own, to use, and to exercise control over all or some of the [nonincome] producing assets, of the income producing assets, of [Marjorie's] total net income and [his own] total net income.'' In addition to directing Shea to transfer Marjo-rie's assets to Paul, the Probate Court ordered Shea, inter alia, to pay Marjorie's total net monthly income of $1, 170.33 to Paul as spousal support, ‘‘which amount . . . is known, identified, and defined as . . . the community spouse allowance in [42 U.S.C. § 1396r-5 (d) (5)][6] and in [Dept. of Social Services, Uniform Policy Manual § 5035.30 (B) (1) (b)].''[7] (Footnote added.) The Probate Court directed that this payment be made retroactive to November 18, 2012, the date Marjorie was admitted to MidState. The Probate Court provided notice of the hearing and a copy of the decree to the commissioner.

         On July 15, 2013, an application was filed with the Department of Social Services (department) seeking Medicaid assistance for Marjorie. The department granted that application but, in doing so, declined to follow the community spouse allowance set in the Probate Court's decree. Instead, the department determined that Marjorie had an applied income obligation that required her to pay $898.45 monthly toward her care from April, 2013, through her death in October, 2013, and that no community spouse allowance was available pursuant to department policy.[8]

         On February 13, 2014, Shea requested an administrative fair hearing for the purpose of challenging the department's refusal to accept the community spouse allowance set by the Probate Court. After a hearing, the commissioner, acting through a hearing officer, issued a decision on October 10, 2014, upholding the denial of the requested community spouse allowance and the determination of Marjorie's applied income obligation. The hearing officer concluded that, under § 17b-261b, the department is the ‘‘sole agency'' tasked with determining eligibility for Medicaid benefits under state and federal law, and the Probate Court lacked the authority to set the community spouse allowance for Medicaid purposes. Specifically, the hearing officer concluded that, once an individual applies for Medicaid under § 45a-655 (d), only the department may set the community spouse allowance. Rejecting the plaintiffs' reliance on 42U.S.C. § 1396r-5 (d) (5), the federal Medic-aid statute addressing preexisting court orders, the hearing officer criticized the plaintiffs for what he described as ‘‘obvious'' forum shopping, observing that it was ‘‘clear from a review of the Probate Court decree and the sequence of events that . . . the Probate Court [was being used] to make a Medicaid eligibility determination, which the law does not permit.'' The hearing officer subsequently denied a timely request for reconsideration.

         On December 8, 2014, the plaintiffs filed an administrative appeal pursuant to General Statutes § 4-183 challenging the commissioner's decision. In its comprehensive memorandum of decision, the trial court observed that this case concerned the interplay between the federal and state statutes implementing the catastrophic coverage act. Emphasizing that no party had challenged the Probate Court's determination with respect whether the support ordered was ‘‘ ‘proper under the circumstances of the case, ' '' the trial court concluded that, consistent with 42 U.S.C. § 1396r-5 (d) (5), § 45a-655 (b) authorized the Probate Court to set the community spouse allowance at the time that it did because Marjo-rie had not yet applied for or received Medicaid benefits. The trial court further determined that the restriction in § 45a-655 (d) applies only when ‘‘an institutionalized conserved person ‘has applied for or is receiving [Medic-aid benefits].' '' The trial court determined that these subsections of § 45a-655 ‘‘thus harmonized the standards the Probate Court must utilize in the approval of a [community spouse allowance] with the Medicaid scheme. If no prior court order has entered then the department is free, indeed required, to apply the standard enunciated by [42 U.S.C. § 1396r-5 (d) (2) through (4)].[9] Where a prior court order regarding a [community spouse allowance] has entered, however, the department is obliged to adopt that amount pursuant to [42 U.S.C.] § 1396r-5 (d) (5).''[10] (Footnote added.) Accordingly, the trial court rendered judgment sustaining the plaintiffs' administrative appeal from the department's community spouse allowance calculation ‘‘that would have resulted in [no] community spouse allowance and $898.45 in applied income rather than [the] prior Probate Court . . . calculation [that] would have resulted in a [community spouse allowance] of $1170.33 and no applied income.'' This appeal followed.

         On appeal, the commissioner argues that 42 U.S.C. § 1396r-5 (d) (2) and (3) sets a uniform national standard for the calculation of community spouse allowances, subject to an exception in 42 U.S.C. § 1396r-5 (d) (5) for court-ordered support, and for ‘‘exceptional circumstances resulting in significant financial duress'' under 42 U.S.C. § 1396r-5 (e) (2), which provides a fair hearing procedure for spouses dissatisfied with their allowances.[11] The commissioner then contends that § 17b-261b implements the federal ‘‘single state agency'' requirement of 42 U.S.C. § 1396a (a) (5), which renders the department the ‘‘sole agency to determine eligibility'' for Medicaid and, therefore, restricts the Probate Court's authority to approve community spousal support to an ‘‘order [that] is consistent with state and federal law.'' The commissioner further contends that the Probate Court exceeded its authority under § 46b-655 (b) because only the department may determine the Medicaid community spouse allowance. As such, the commissioner then argues that the Probate Court exceeded its limited authority under § 45a-655 (d) by ordering community spouse support in an amount that exceeded that which the department could order pursuant to 42 U.S.C. § 1396r-5 (2) through (4). To this end, the commissioner cites Gomprecht v. Gomprecht, 86 N.Y.2d 47, 652 N.E.2d 936, 629 N.Y.S.2d 190 (1995), and M.E.F. v. A.B.F., 393 N.J.Super. 543, 925 A.2d 12 (App. Div.), cert. denied, 192 N.J. 479, 932 A.2d 29 (2007), for the proposition that the retroactive nature of the Medicaid determination, which precedes the date of the probate decree, limited the court's discretion under § 46b-655 (d) to render an award that exceeded the federal limitations.

         In response, the plaintiffs, supported by the amicus curiae, the Office of the Probate Court Administrator, [12]emphasize the complementary roles of the Probate Court and the department within the Medicaid scheme as envisioned by § 17b-261b (b), which requires the Probate Court and the applicant to provide notice of the spousal support application and order to the department, which then has the right to appear at the hearing on the application. Consistent with the federal single state agency requirement, the plaintiffs contend that § 17b-261b (b) allows the commissioner to take a position on a proposed spousal support order before it is rendered by the court pursuant to § 45a-655 (b), insofar as the federal and state statutes and § 5035.30 (B) (1) (b) of the Uniform Policy Manual require it to follow preexisting court orders. Also relying on M.E.F. v. A.B.F., supra, 393 N.J.Super. 543, the plaintiffs argue that the trial court's interpretation of the federal and state statutes is consistent with the plain language of § 45a-655 (b) and, particularly, the tense of the verbs used therein; they contend that the federal single state agency requirement under §§ 17b-261b and 45a-655 (d) was not triggered because the Probate Court application and decree preceded the application for Medicaid. Citing Dept. of Social Services v. Saunders, 247 Conn. 686, 715, 724 A.2d 1093 (1999), the plaintiffs further argue that the department's argument improperly seeks to diminish the Probate Court's statutory authority. We agree with the plaintiffs and conclude that, under the plain and unambiguous language of §§ 45a-655 and 17b-261b, and 42 U.S.C. § 1396r-5 (d) (5), the department was bound by the Probate Court's preexisting spousal support order when it determined that there would be no community spouse allowance under department policy.

         In considering whether the Probate Court's order was binding upon the department's determination of the community spouse allowance, we first observe that the ‘‘Probate Court is a court of limited jurisdiction pre-scribedby statute, and it may exercise only such powers as are necessary to the performance of its duties. . . . As a court of limited jurisdiction, it may act only when the facts and circumstances exist upon which the legislature has conditioned its exercise of power. . . . Such a court is without jurisdiction to act unless it does so under the precise circumstances and in the manner particularly prescribed by the enabling legislation.'' (Citations omitted; internal quotation marks omitted.) Heussner v. Hayes, 289 Conn. 795, 802-803, 961 A.2d 365 (2008); see also In re Bachand, 306 Conn. 37, 59-61, 49 A.3d 166 (2012) (Probate Court's limited jurisdiction creates constraints over its authority, even with respect to matter over which Superior Court has concurrent jurisdiction). Thus, whether the Probate Court had jurisdiction to render the decree challenged by the commissioner presents a question of statutory interpretation. See In re Bachand, supra, 42.

         Given the procedural posture of this case, we review ‘‘the trial court's judgment pursuant to the Uniform Administrative Procedure Act (UAPA), General Statutes § 4-166 et seq. Under the UAPA, it is [not] the function . . . of this court to retry the case or to substitute its judgment for that of the administrative agency. . . . Even for conclusions of law, [t]he court's ultimate duty is only to decide whether, in light of the evidence, the [agency] has acted unreasonably, arbitrarily, illegally, or in abuse of its discretion. . . . [Thus] [c]onclu-sions of law reached by the administrative agency must stand if the court determines that they resulted from a correct application of the law to the facts found and could reasonably and logically follow from such facts. . . . [Similarly], this court affords deference to the construction of a statute applied by the administrative agency empowered by law to carry out the statute's purposes. . . . Cases that present pure questions of law, however, invoke a broader standard of review than is . . . involved in deciding whether, in light of the evidence, the agency has acted unreasonably, arbitrarily, illegally or in abuse of its discretion. . . . Furthermore, when a state agency's determination of a question of law has not previously been subject to judicial scrutiny . . . the agency is not entitled to special deference. . . . We have determined, therefore, that the traditional deference accorded to an agency's interpretation of a statutory term is unwarranted when the construction of a statute . . . has not previously been subjected to judicial scrutiny [or to] . . . a governmental agency's time-tested interpretation . . . . Even if time-tested, we will defer to an agency's interpretation of a statute only if it is reasonable; that reasonableness is determined by [application of] our established rules of statutory construction. . . .

         ‘‘When construing a statute, [o]ur fundamental objective is to ascertain and give effect to the apparent intent of the legislature. . . . In seeking to determine that meaning, General Statutes § 1-2z directs us first to consider the text of the statute itself and its relationship to other statutes. If, after examining such text and considering such relationship, the meaning of such text is plain and unambiguous and does not yield absurd or unworkable results, extratextual evidence of the meaning of the statute shall not be considered. . . . The test to determine ambiguity is whether the statute, when read in context, is susceptible to more than one reasonable interpretation. . . . When a statute is not plain and unambiguous, we also look for interpretive guidance to the legislative history and circumstances surrounding its enactment, to the legislative policy it was designed to implement, and to its relationship to existing legislation and common law principles governing the same general subject matter . . . . The question of statutory interpretation presented in this case is a question of law subject to plenary review.'' (Citations omitted; internal quotation marks omitted.) Commissioner of Public Safety v. Freedom of Information Commission, 312 Conn. 513, 525-27, 93 A.3d 1142 (2014).

         For purposes of the UAPA, no special deference is required because there is no claim that the department's construction of the applicable statutes is time-tested, or has previously been subject to judicial scrutiny. Thus, ‘‘[i]n order properly to characterize the issues on appeal, it is necessary to overview the complex of statutes and regulations governing [M]edicaid eligibility for institutionalized applicants. The [M]edicaid program, established in 1965 as Title XIX of the Social Security Act, and codified at 42 U.S.C. § 1396 et seq., is a joint federal-state venture providing financial assistance to persons whose income and resources are inadequate to meet the costs of necessary medical care. . . . States participate voluntarily in the [M]edicaid program, but participating states must develop a plan, approved by the [S]ecretary of [H]ealth and [H]uman [S]ervices, containing reasonable standards . . . for determining eligibility for and the extent of medical assistance . . . . Connecticut has elected to participate in the [M]edicaid program and has assigned to the department the task of administering the program. . . . The department, as part of its uniform policy manual, has promulgated regulations governing the administration of Connecticut's [M]edicaid system. See General Statutes § 17b-260.

         ‘‘In 1988, Congress passed into law the . . . catastrophic [coverage] act . . . . [The provision subsequently codified as 42 U.S.C. § 1396r-5] was intended . . . to ease the financial burden placed on a community spouse[13] under the prior statutory regime that required the institutionalized spouse to spend down a large portion of the couple's resources, and thus impoverish the community spouse, before becoming eligible for [M]edicaid. See, e.g., Krueger Estate v. Richland County Social Services, 526 N.W.2d 456, 458 (N.D. 1994) . . . . Under the catastrophic [coverage] act, a community spouse is entitled to receive a community spouse resource allowance (resource allowance), which is approximately one half of the couple's total liquid resources or $60, 000, adjusted annually for inflation, whichever is less. 42 U.S.C. § 1396r-5 (f) (2) . . . . The resource allowance is protected from the institutionalized applicant's health care obligations and does not count against the applicant's financial eligibility.

         ‘‘In addition, under the catastrophic [coverage] act, a community spouse is entitled to a minimum monthly maintenance needs allowance (minimum needs allow-ance).[14] 42 U.S.C. § 1396r-5 (d) (3) . . . . If the community spouse's income from outside sources is insufficient to meet his minimum needs allowance, the institutionalized spouse is permitted to bridge this deficit by transferring income to the community spouse. 42 U.S.C. § 1396r-5 (d) (1) (B) and (2). If the transferred income is insufficient to reach the minimum needs allowance, the community spouse may then apply for an increase in his resource allowance to an amount adequate to fund his minimum needs allowance. 42 U.S.C. § 1396r-5 (e) (2) (C); see Krueger Estate v. Rich-land County Social Services, supra, 526 N.W.2d 459. Because this increase in the resource allowance results from a transfer of resources from the institutionalized spouse to the community spouse, [15] the value of the institutionalized spouse's resources is brought closer to the eligibility level.[16]

         ‘‘Under 42 U.S.C. § 1396r-5 [(e) (2)][17] a community spouse may obtain an increase in his [resource allowance or] his minimum needs allowance [as determined by the department] by establishing, at a fair hearing, a need for additional income due to exceptional circumstances resulting in significant financial duress . . . .'' (Citations omitted; footnotes added and omitted; internal quotation marks omitted.) Burinskas v. Dept. of Social Services, 240 Conn. 141, 148-50, 691 A.2d 586 (1997); see Fagan v. Bremby, 244 F.Supp.3d 280, 281-82 (D. Conn. 2017); see also Palomba-Bourke v. Commissioner of Social Services, 312 Conn. 196, 203- 206, 92 A.3d 932 (2014).

         As is required by § 1-2z, we begin with the text of the statutes at issue, starting with § 45a-655 (b) and (d), which governs spousal support orders. Section 45a-655 (b) provides that the ‘‘conservator of the estate of a married person may apply such portion of the property of the conserved person to the support, maintenance and medical treatment of the conserved person's spouse which the Court of Probate, upon hearing after notice, decides to be proper under the circumstances of the case.'' Section 45a-655 (d), however, limits the authority of the conservator and the Probate Court with respect to ‘‘an institutionalized person who has applied for or is receiving . . . medical assistance, '' by providing that, ‘‘[n]otwithstanding the provisions of subsections (a) and (b) of this section, in the case of an institutionalized person who has applied for or is receiving such medical assistance, no conservator shall apply and no court shall approve the application of (1) the net income of the conserved person to the support of the conserved person's spouse in an amount that exceeds the monthly income allowed a community spouse as determined by the [department] pursuant to [42 U.S.C. 1396r-5 (d) (2) through (4)], or (2) any portion of the property of the conserved person to the support, maintenance and medical treatment of the conserved person's spouse in an amount that exceeds the amount determined allowable by the department pursuant to [42 U.S.C. § 1396r-5 (f) (1) and (2)], notwithstanding the provisions of [42 U.S.C. § 1396r-5 (f) (2) (A) (iv)], unless such limitations on income would result in significant financial duress.'' (Emphasis added.)

         When these subsections are read in juxtaposition, it is apparent that the legislature's use of the word ‘‘notwithstanding'' in subsection (d) indicates its desire to carve out an exception to the authority of the Probate Court and conservator when a person has sought or is receiving medical assistance, insofar as it limits the court's authority to award support to the amount approved by the department pursuant to 42 U.S.C § 1396r-5 (d) (2) through (4). See Gay & Lesbian Law Students Assn. v. Board of Trustees, 236 Conn. 453, 473, 673 A.2d 484 (1996). ‘‘[If] there are two provisions in a statute, one of which is general and designed to apply to cases generally, and the other is particular and relates to only one case or subject within the scope of a general provision, then the particular provision must prevail; and if both cannot apply, the particular provision will be treated as an exception to the general provision.'' (Internal quotation marks omitted.) Gifford v. Freedom of Information Commission, 227 Conn. 641, 652-53, 631 A.2d 252 (1993). ‘‘[W]e have long held that provisos and exceptions to statutes are to be strictly construed with doubts resolved in favor of the general rule rather than the exception and that those who claim the benefit of an exception under a statute have the burden of proving that they come within the limited class for whose benefit it was established.'' (Internal quotation marks omitted.) Gay & Lesbian Law Students Assn. v. Board of Trustees, supra, 473-74; see also Gifford v. Freedom of Information Commission, supra, 655 n.15 (describing use of language following word ‘‘notwithstanding'' to broaden or narrow scope of exception).

         Moreover, the legislature's use of the present perfect and present progressive verb tenses in § 45a-655 (d) is significant. Specifically, the legislature has restricted the Probate Court's authority only in those situations in which the institutionalized spouse ‘‘has applied for or is receiving'' medical assistance. General Statutes § 45a-655 (d); see also Schieffelin & Co. v. Dept. of Liquor Control, 194 Conn. 165, 175, 479 A.2d 1191 (1984) (‘‘[t]he use of the present perfect tense of a verb indicates an action or condition that was begun in the past and is still going on or was just completed in the present''); Pollansky v. Pollansky, 144 Conn.App. 188, 193, 71 A.3d 1276 (noting that present perfect tense as used in notice to quit statute, General Statutes § 47a-23 [a] [3], contemplates ‘‘termination [of tenancy] that occurs simultaneously with the delivery of a notice to quit''), cert. denied, 310 Conn. 919, 76 A.3d 633 (2013). Moreover, ‘‘[w]here a statute, with reference to one subject contains a given provision, the omission of such provision from a similar statute concerning a related subject . . . is significant to show that a different intention existed.'' (Internal quotation marks omitted.) State v. B.B., 300 Conn. 748, 759, 17 A.3d 30 (2011). Put differently, it appears that the commissioner asks us to rewrite § 45a-655 by importing restrictions from subsection (d) into subsection (b) where none exists, which violates the well established maxim that, ‘‘[a]s a general matter, this court does not read language into a statute. . . . [W]e are bound to interpret legislative intent by referring to what the legislative text contains, not by what it might have contained.'' (Citation omitted; internal quotation marks omitted.) State v. George J., 280 Conn. 551, 570, 910 A.2d 931 (2006), cert. denied, 549 U.S. 326, 127 S.Ct. 1919, 167 L.Ed.2d 573 (2007).

         The commissioner, however, contends to the contrary, arguing that, under the plain language of § 45-655 (d), the conservator is precluded from paying spousal support in excess of that permitted under the Medicaid scheme, despite the existence of a preexisting Probate Court order mandating a greater support amount. We disagree. First, it is inconsistent with the plain language of the statute in two different ways. The use in § 45a-655 (d) of the conjunctive word ‘‘and'' between the phrases ‘‘no conservator shall apply'' and ‘‘no court shall approve the application'' does not suggest a statutorily mandated change to an existing court order but, rather, imparts a limitation on the conservator's authority to file an application, and the court's authority to approve that application once made by the conservator, upon the existence of certain conditions precedent-namely, an application for, or the receipt of, medical assistance. Put differently, had the legislature intended to limit the authority of the conservator independent of the Probate Court, it, as it did in defining the condition precedent in the preceding clause, could have used the disjunctive word ‘‘or'' to link those terms. See, e.g., State v. Dennis, 150 Conn. 245, 248, 188 A.2d 65 (1963) (‘‘[t]he use of the disjunctive ‘or' between the two parts of the statute indicates a clear legislative intent of separability''). That this sentence governs only the actions of the conservator and the Probate Court in concert is further demonstrated by the structure of the statute, insofar as the first sentence of § 45a-655 (d) pertains only to the obligations of the conservator by herself, providing: ‘‘In the case of any person receiving public assistance, state administered general assistance or Medicaid, the conservator of the estate shall apply toward the cost of care of such person any assets exceeding limits on assets set by statute or regulations adopted by the Commissioner of Social Services.''

         Second, as the Office of the Probate Court Administrator aptly points out in its amicus brief, the commissioner's interpretation, which would potentially require the conservator to act contrary to an existing Probate Court support order, puts the conservator in an ‘‘untenable'' situation because ‘‘when the Probate Court has expressly authorized or approved specific conduct by the conservator, the conservator is not acting on behalf of the conservatee, but as an agent of the Probate Court.'' Gross v. Rell, 304 Conn. 234, 251, 40 A.3d 240 (2012); see also Elmendorf v. Poprocki, 155 Conn. 115, 118, 230 A.2d 1 (1967) (Probate Court ‘‘is primarily entrusted with the care and management of the ward's estate, and, in many respects, the conservator is but the agent of the court. . . . A conservator has only such powers as are expressly or impliedly given to him by statute. . . . In exercising those powers, he is under the supervision and control of the Probate Court.'' [Citations omitted.]); Johnson's Appeal from Probate, 71 Conn. 590, 598, 42 A. 662 (1899) (noting that conservator ‘‘exercises his statutory power . . . subject to [the Probate Court's] power to approve or disapprove of his action''); cf. Gross v. Rell, supra, 254 (conservator is fiduciary of conservatee when action has not been approved or authorized by Probate Court). In the absence of clear and unambiguous statutory language nullifying the existing Probate Court order, that order remains effective; we decline to interpret statutes in a manner that would require an agent or officer of that court to disregard such an order.[18]

         Although we agree with the commissioner that we must read § 45a-655 in conjunction with § 17b-261b, which sets out the obligations of the Probate Court to the commissioner with regard to applications for spousal support, such a reading does not dictate the result sought by the commissioner. Section 17b-261b implements the single state agency requirement under the federal Medicaid statutes; see 42 U.S.C. § 1396a (a) (5) (2012); insofar as it provides that the department ‘‘shall be the sole agency to determine eligibility for assistance and services under programs operated and administered by said department.'' General Statutes § 17b-261b (a). It also, however, contemplates the Probate Court having a role in that process, particularly with respect to the issuance of spousal support orders. Section 17b-261b (c) limits the authority of the Probate Court to approve an application for an order of community spousal support, providing: ‘‘No probate court shall approve an application for spousal support of a community spouse unless (1) notice is provided in accordance with subsection (b) of this section, and (2) the order is consistent with state and federal law.'' Section 17b-261b (b), in addition to setting forth the obligations of ‘‘[a]ny person filing an application'' and the Probate Court to provide notice of the application, the hearing on the application, and the court's order to the commissioner, specifically affords the ‘‘commissioner or a des-ignee'' the right to ‘‘appear at such hearing and [to] present the commissioner's position as to the application in person orin writing.'' As the Office of the Probate Court Administrator contends in its amicus brief, if the terms of § 45a-655 (d) effectively nullified any existing order of spousal support upon an application for Medic-aid, there would be no need for § 17b-261b, which the legislature enacted nine years after § 45a-655 (d), [19] mandating that the commissioner receive notice and the opportunity to be heard in the first instance with respect to any application for spousal support. ‘‘In cases in which more than one [statutory provision] is involved, we presume that the legislature intended [those provisions] to be read together to create a harmonious body of law . . . and we construe the [provisions], if possible, to avoid conflict between them.'' (Internal quotation marks omitted.) Cardenas v. Mixcus, 264 Conn. 314, 326, 823 A.2d 321 (2003); see also id., 322-23 (‘‘[w]e presume that laws are enacted in view of existing relevant statutes'' [internal quotation marks omitted]). Accordingly, the commissioner's suggested reading of the statutes at issue in this appeal would run afoul of the ‘‘basic tenet of statutory construction that the legislature [does] not intend to enact meaningless provisions. . . . Because [e]very word and phrase [of a statute] is presumed to have meaning . . . [a statute] must be construed, if possible, such that no clause, sentence or word is superfluous, void or insignificant.'' (Internal quotation marks omitted.) Tomick v. United Parcel Service, Inc., 324 Conn. 470, 483, 153 A.3d 615 (2016).

         Indeed, the continued enforcement of an order rendered under § 45a-655 (b) is wholly consistent with federal law, as is required by § 17b-261b (c). The federal statute governing community spouse support sets forth a detailed formula for calculating the community spouse allowance; see 42 U.S.C. § 1396r-5 (d) (2) through (4) (2012); subject to the exception governing preexisting court orders. 42 U.S.C. § 1396r-5 (d) (5) (2012). That exception provides: ‘‘If a court has entered an order against an institutionalized spouse for monthly income for the support of the community spouse, the community spouse monthly income allowance for the spouse shall be not less than the amount of the monthly income so ordered.'' (Emphasis added.) 42 U.S.C. § 1396r-5 (d) (5) (2012). Congress' use of the words ‘‘has entered, '' stated in the present perfect tense, indicates that 42 U.S.C. § 1396r-5 (d) (5) contemplates only court orders in existence at the time of the eligibility determination, such as the Probate Court decree at issue in the present appeal.[20] See Schieffelin & Co. v. Dept. of Liquor Control, supra, 194 Conn. 175.

         The sister state cases upon which the parties rely do not directly counsel a result with respect to the language of our state statutes, but simply stand for the proposition that the relief available in the judicial forum is uniquely dependent on the state laws that intersect with the federal Medicaid statute. We do, however, find most persuasive M.E.F. v. A.B.F., supra, 393 N.J.Super. 543, a decision from New Jersey's intermediate appellate court that, in many ways, presents the mirror image of the present case. In M.E.F., the court directly considered the ‘‘relationship between the ‘[court-ordered] support' and ‘fair hearing' provisions of the [catastrophic coverage act] in determining the [minimum monthly needs allowance] of a community spouse who seeks an upward modification of the allowance provided by the state . . . .'' Id., 547. In that case, the institutionalized spouse had spent down his assets and was already receiving Medicaid. Id., 548. Rather than challenge the agency's determination of her minimum needs allowance through the fair hearing process, the community spouse renewed a motion for support previously filed in state family court, with notice to the state's social services agency. Id., 548-49. After reviewing the legislative history of the catastrophic coverage act, the New Jersey court stated that the ‘‘use of the past tense'' in 42 U.S.C. § 1396r (d) (5) with respect to court-ordered support ‘‘suggests . . . that a community spouse . . . cannot, at this point, seek such an order, not having previously obtained one. Indeed, a strong argument can be made that the [court-ordered] support provision is applicable only when such support has been obtained during spend-down and prior to a determination of Medicaid eligibility. Such an interpretation would be consistent with a Congressional concern, expressed in the context of a discussion of the treatment of income, protection of income for the community spouse, and transfer of resources, that spouses not be worse off under proposed legislation than they were under existing law, which in some instances recognized spousal support orders.''[21] (Emphasis added.) Id., 554. The court nevertheless declined to resolve whether the fair hearing and court order provisions present two parallel alternatives for relief, given the posture of the case. Id., 557. Instead, to avoid the potential for ‘‘forum shopping'' and ‘‘parallel litigation, '' the court held that, once the community spouse ‘‘embarked upon the administrative path by receiving and challenging the [monthly needs allowance] provided to her, [she was] limited to that path until a final administrative determination has been reached.''[22] Id., 557-59; see also H.K. v. Division of Medical Assistance & Health Services, 379 N.J.Super. 321, 329-31, 878 A.2d 16 (App. Div.) (declining to give effect to nonadversarial divorce order of support, rendered after filing of Medicaid application), cert. denied, 185 N.J. 393, 886 A.2d 663 (2005); Gomprecht v. Gom-precht, supra, 86 N.Y.2d 49-52 (family court required to apply minimum monthly needs and resource allowance standard under social services statute, along with ‘‘exceptional circumstances'' standard for justification of increased support, in support action brought by community spouse against institutionalized spouse who was receiving Medicaid); Blumberg v. Dept. of Human Services, Docket No. M2000-00237-COA-R3-CV, 2000 WL 1586454, *2-34 (Tenn.App. October 25, 2000) (rejecting social services agency's reliance on single state agency provision set forth in 42 U.S.C. § 1396a [a] [5], and holding that agency was ‘‘without the authority'' to ignore family court order of support to the community spouse because, had Congress wanted to foreclose courts from setting community spouse allowance, ‘‘it could simply have stated in precise language that the administrative process is the only procedure available'').

         Finally, at oral argument before this court, certain colloquies suggested that this interpretation of §§ 17b-261b and 45a-655 (b) and (d), and might well result in potential inequities among Medicaid recipients and a greater drain on the public fisc, insofar as persons with greater access to professional estate planning services would have the ability to maximize the preservation of their assets and income simply by obtaining a spousal support order from the Probate Court prior to filing the institutionalized spouse's application for Medicaid.[23]The department is not, however, powerless to protect the public fisc from such estate planning maneuvers. We emphasize that the department has statutory standing to appear in Probate Court under § 17b-261b (b) in response to any application for spousal support under § 45a-655, [24] and may advocate for the issuance of a spousal support order that reflects the potential for the future issuance of Medicaid benefits, consistent with ‘‘the circumstances of the case.''[25] General Statutes § 45a-655 (b); see M.E.F. v. A.B.F., supra, 393 N.J.Super. 558');">393 N.J.Super. 558 (‘‘dual purposes'' of catastrophic coverage act-''to ensure that the community spouse has sufficient, but not excessive, income and to ensure that individuals not be permitted to avoid payment of their own fair share for long-term care-are certainly relevant considerations'' with respect to family court's application of statute that ‘‘permit[s] consideration of spousal ‘actual need, ' ability to pay, and ‘[a]ny other factors which the court may deem relevant' ''); see also Gomprecht v. Gomprecht, supra, 86 N.Y.2d 52 (concluding that ‘‘due regard to the circumstances of the respective parties'' standard of spousal support statute requires consideration of Medicaid factors with respect to institutionalized spouse already receiving Medicaid, including requiring showing of ‘‘exceptional circumstances'' to justify increase in support, and ‘‘[t]he fact that one spouse is institutionalized at the public expense is a factor to be considered''). Should the department still deem this process insufficient to protect the public fisc, it is always free to seek corrective legislative action.[26]See, e.g., Morris v. Oklahoma Dept. of Human Services, 685 F.3d 925, 928 (10th Cir. 2012) (‘‘[a]lthough we understand the district court's concerns regarding the exploitation of what can only be described as a loophole in the Medicaid statutes, we conclude that the problem can only be addressed by Congress''); accord Commissioner of Public Safety v. Freedom of In formation Com-mission, supra, 312 Conn. 550 (‘‘[t]he General Assembly retains the prerogative to modify or clarify [General Statutes] § 1-215 as it sees fit'').

         Accordingly, insofar as the department failed to take advantage of its opportunity to seek appropriate relief in the Probate Court before an application for Medicaid was filed, we conclude that the Probate Court's spousal support order, rendered pursuant to the plain and unambiguous language of § 45a-655, was binding upon the department. The trial court, therefore, properly sustained the plaintiffs' administrative appeal.

         The judgment is affirmed.

         In this opinion the other justices concurred.

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Notes:

[*] The listing of justices reflects their seniority status on this court as of the date of oral argument.

[**] February 1, 2018, the date that this decision was released as a slip opinion, is the operative date for all substantive and ...


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